<!DOCTYPE html>
<html class="x-admin-sm">
	<head>
		<meta charset="UTF-8">
		<title>每月核对</title>
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	<body>
		<div class="layui-fluid">
			<div class="layui-row">
				<form class="layui-form">
					<div class="layui-form-item">
						<label for="L_email" class="layui-form-label">
							<span class="x-red">*</span>结算编号</label>
						<div class="layui-input-inline">
							<input type="text" id="L_email" name="email" required="" lay-verify="didian" autocomplete="off" class="layui-input"></div>
					</div>
					<div class="layui-form-item">
						<label for="L_time" class="layui-form-label">
							<span class="x-red">*</span>核对编号</label>
						<div class="layui-input-inline">
							<input type="text" id="L_time" name="time" required="" lay-verify="time" autocomplete="off" class="layui-input"></div>
					</div>
					<div class="layui-form-item">
						<label for="L_number" class="layui-form-label">
							<span class="x-red">*</span>收费表数</label>
						<div class="layui-input-inline">
							<input type="text" id="L_number" name="number" required="" lay-verify="pass" autocomplete="off" class="layui-input"></div>
					</div>
					<div class="layui-form-item">
						<label for="L_rename" class="layui-form-label">
							<span class="x-red">*</span>费用单价</label>
						<div class="layui-input-inline">
							<input type="text" id="L_rename" name="rename" required="" lay-verify="repass" autocomplete="off" class="layui-input"></div>
					</div>
					<div class="layui-form-item">
						<label for="L_renumber" class="layui-form-label">
							<span class="x-red">*</span>总金额</label>
						<div class="layui-input-inline">
							<input type="text" id="L_renumber" name="renumber" required="" lay-verify="repass" autocomplete="off" class="layui-input"></div>
					</div>
					<div class="layui-form-item">
						<label for="L_rehao" class="layui-form-label">
							<span class="x-red">*</span>实收费用</label>
						<div class="layui-input-inline">
							<input type="text" id="L_rehao" name="rehao" required="" lay-verify="repass" autocomplete="off" class="layui-input"></div>
					</div>
					<div class="layui-form-item">
						<label for="L_rtime" class="layui-form-label">
							<span class="x-red">*</span>付款方式</label>
						<div class="layui-input-inline">
							<input type="text" id="L_rtime" name="rtime" required="" lay-verify="repass" autocomplete="off" class="layui-input"></div>
					</div>
					<div class="layui-form-item">
						<label for="L_riqi" class="layui-form-label">
							<span class="x-red">*</span>是否开发票</label>
						<div class="layui-input-inline">
							<input type="text" id="L_riqi" name="riqi" required="" lay-verify="repass" autocomplete="off" class="layui-input"></div>
					</div>
					<div class="layui-form-item">
						<label for="L_riqi" class="layui-form-label">
							<span class="x-red">*</span>税号</label>
					</div>
					<div class="layui-form-item">
						<label for="L_riqi" class="layui-form-label">
							<span class="x-red">*</span>公司全称</label>
					</div>
					<div class="layui-form-item">
						<label for="L_riqi" class="layui-form-label">
							<span class="x-red">*</span>联系人</label>
					</div>
					<div class="layui-form-item">
						<label for="L_riqi" class="layui-form-label">
							<span class="x-red">*</span>联系电话</label>
					</div>
					<div class="layui-form-item">
						<label for="L_riqi" class="layui-form-label">
							<span class="x-red">*</span>创建人</label>
					</div>
					<div class="layui-form-item">
						<label for="L_riqi" class="layui-form-label">
							<span class="x-red">*</span>创建时间</label>
					</div>
					<div class="layui-form-item">
						<label for="L_riqi" class="layui-form-label">
							<span class="x-red">*</span>更新人</label>
					</div>
					<div class="layui-form-item">
						<label for="L_riqi" class="layui-form-label">
							<span class="x-red">*</span>更新时间</label>
					</div>
					<div class="layui-form-item">
						<label for="L_repass" class="layui-form-label"></label>
						<button class="layui-btn" lay-filter="add" lay-submit="">增加</button></div>
				</form>
			</div>
		</div>
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